Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

558 questions · 586 findings · 46 reviews · Pregnancy and Childbirth

No studies found 151 · 25.8%GRADE not reported 53 · 9%Very low 124 · 21.2%Low 157 · 26.8%Moderate 76 · 13%High 25 · 4.3%

Standard care plus IV tranexamic acid vs placebo or usual care

Hysterectomy to control bleeding · women with primary postpartum haemorrhage following vaginal or caesarean birth

Standard care plus IV tranexamic acid showed no clear difference in surgical intervention to control bleeding: Hysterectomy compared with placebo or standard care alone (high certainty).

1 finding from 1 review

Standard care plus IV tranexamic acid vs placebo or usual care

Side effects of the intervention: Any maternal vascular occlusive event · women with primary postpartum haemorrhage following vaginal or caesarean birth

Standard care plus IV tranexamic acid showed no clear difference in side effects of the intervention: Any maternal vascular occlusive… compared with placebo or standard care alone (moderate certainty).

1 finding from 1 review

Misoprostol vs surgery

Unplanned surgical intervention · incomplete miscarriage

Misoprostol may leads to higher unplanned surgical intervention compared with surgery (low certainty).

1 finding from 1 review

Any supplements containing iron and folic acid vs same supplements without iron nor folic acid (no iron nor folic acid or placebo)

Side effects (any reported throughout the intervention period) (ALL) · pregnant women

(Maternal outcomes) Any supplements containing iron and folic acid probably leads to higher side effects (any reported throughout the intervention period) (ALL) compared with same supplements without iron nor folic acid (no iron nor folic acid… (moderate certainty).

1 finding from 1 review

Any supplements containing iron vs same supplements without iron or no treatment/placebo (no iron or placebo)

Side effects (any reported throughout the intervention period) (ALL) · pregnant women

It is very uncertain whether (Maternal outcomes) Any supplements containing iron changes side effects (any reported throughout the intervention period) (ALL) compared with same supplements without iron or no treatment/placebo (no iron or… (very low certainty).

1 finding from 1 review

Tranexamic acid vs placebo/no treatment

Use of additional medical interventions to control PPH · pregnant women undergoing vaginal or caesarean birth who received TA for the prevention of postpartum haemorrhage

Tranexamic acid probably leads to lower use of additional medical interventions to control PPH compared with placebo/no treatment (moderate certainty).

1 finding from 1 review

Any intermittent iron regimen (with or without other vitamins and minerals) vs daily regimen (with same vitamins and minerals)‐maternal outcomes

Participants with at least some Side Effects · Women receiving supplements in pregnancy

It is very uncertain whether any intermittent iron regimen (with or without other vitamins and… changes side effects (any reported throughout intervention period) compared with daily regimen (with same vitamins and minerals)‐maternal outcomes (very low certainty).

1 finding from 1 review

Intervention not reported

Manual removal of placenta Manual removal after intervention · women with retained placenta

It is very uncertain whether the intervention changes manual removal of placenta Manual removal after intervention (very low certainty).

1 finding from 1 review

Intervention not reported

Severe postpartum haemorrhage Objectively or subjectively measured after intervention/Estimated blood loss in ML. · women with retained placenta

It is very uncertain whether the intervention changes severe postpartum haemorrhage Objectively or subjectively measured… (very low certainty).

1 finding from 1 review

Intervention not reported

Mean blood loss Objectively or subjectively measured after intervention/Mean blood loss in ML. · women with retained placenta
1 finding from 1 review

Supplementation with folate vs no intervention, placebo or other micronutrients without folate (neonatal outcomes)

Neural tube defects (All) · all women who become pregnant or were 12 or less weeks' pregnant at the time of the intervention

Supplementation with folate leads to lower neural tube defects (All) compared with no intervention, placebo or other micronutrients without folate… (high certainty).

1 finding from 1 review

Supplementation with folate vs no intervention, placebo or other micronutrients without folate (neonatal outcomes)

Miscarriage · all women who become pregnant or were 12 or less weeks' pregnant at the time of the intervention

Supplementation with folate showed no clear difference in miscarriage (All) compared with no intervention, placebo or other micronutrients without folate… (moderate certainty).

1 finding from 1 review

Supplementation with folate vs no intervention, placebo or other micronutrients without folate (neonatal outcomes)

Cleft lip (All) · all women who become pregnant or were 12 or less weeks' pregnant at the time of the intervention

Supplementation with folate showed no clear difference in cleft lip (All) compared with no intervention, placebo or other micronutrients without folate… (low certainty).

1 finding from 1 review

Supplementation with folate vs no intervention, placebo or other micronutrients without folate (neonatal outcomes)

Cleft palate (All) · all women who become pregnant or were 12 or less weeks' pregnant at the time of the intervention

Supplementation with folate showed no clear difference in cleft palate (All) compared with no intervention, placebo or other micronutrients without folate… (low certainty).

1 finding from 1 review

Supplementation with folate vs no intervention, placebo or other micronutrients without folate (neonatal outcomes)

Congenital cardiovascular anomalies (All) · all women who become pregnant or were 12 or less weeks' pregnant at the time of the intervention

Supplementation with folate showed no clear difference in congenital cardiovascular anomalies (All) compared with no intervention, placebo or other micronutrients without folate… (low certainty).

1 finding from 1 review

Supplementation with folate vs no intervention, placebo or other micronutrients without folate (neonatal outcomes)

Other congenital anomalies (All) · all women who become pregnant or were 12 or less weeks' pregnant at the time of the intervention

Supplementation with folate showed no clear difference in other congenital anomalies (All) compared with no intervention, placebo or other micronutrients without folate… (low certainty).

1 finding from 1 review